No abstract

An increasing number of studies refer to sexual wellbeing and/or seek to measure it, and the term appears across various policy documents, including sexual health frameworks in the UK.We conducted a rapid review to determine how sexual wellbeing has been defined, qualitatively explored and quantitatively measured. Eligible studies selected for inclusion from OVID Medline, PsychInfo, PubMed, Embase, CINAHL were: in English language, published after 2007, were peer-reviewed full articles, focused on sexual wellbeing (or proxies for, e.g. satisfaction, function), and quantitatively or qualitatively assessed sexual wellbeing. We included studies with participants aged 16-65. Given study heterogeneity, our synthesis and findings are reported using a narrative approach. We identified 162 papers, of which 10 offered a definition of sexual wellbeing. Drawing upon a socio-ecological model, we categorised the 59 dimensions we identified from studies under three main domains: cognitive-affect (31 dimensions); inter-personal (22 dimensions); and socio-cultural (6 dimensions). Only 11 papers were categorised under the socio-cultural domain, commonly focusing on gender inequalities or stigma. We discuss the importance of conceptualising sexual wellbeing as individually experienced but socially and structurally influenced, including assessing sexual wellbeing freedom: a person's freedom to achieve sexual wellbeing, or their real opportunities and liberties.

The idea that women lie about rape is a long standing rape myth with little or no supporting evidence. Previous research has demonstrated a belief in high levels of false allegations among police officers, despite no evidence to suggest rape is falsely reported more than other crimes. This has implications for complainants' willingness to report sexual violations, for the treatment of complainants within the justice system, and wider societal understandings about what constitutes rape. The data that informs this paper comes from an Economic and Social Research Council-funded study that focussed on rape attrition and the institutional response to rape. Forty in-depth qualitative interviews were conducted with serving police officers in a UK force who regularly deal with reported cases of rape, and explored perceptions, practices and processes around rape. The research found police officers' estimate of false allegations varies widely from 5 to 90%. The paper will discuss how police officers make judgements about perceived veracity of complainants in rape cases. This will demonstrate that whilst significant progress has been made in how police officers and police forces respond to rape, gender stereotypes about women as deceitful, vengeful and ultimately regretful of sexual encounters, continue to pervade the thinking of some officers. It will show that police officers differentiate between 'types' of reports they consider to be false, and operate with a notional 'hierarchy' of presumed false allegations that ranges from vengeful/malicious to mistaken/ confused, with a corresponding reducing level of culpability attributed to women for the supposedly false allegation. It concludes that this serves to reinforce a culture that both supports and reproduces gender inequality and its manifestation in the form of sexual violence, and that intervention, training and institutional and policy frameworks are not wholly successful in addressing sexual violence in this context.

No abstract

Objective The aims of this study were to determine cost effectiveness of screening for Chlamydia trachomatis in hospital-based antenatal and gynaecology clinics, and community-based family planning clinics. Additionally, women's views of screening were determined in the hospital-based clinics. Design Cost effectiveness based on decision model. Model probabilities were generated for a hypothetical sample of 250 women in each age group in each setting, based on prevalence studies, published data and expert opinion. A prospective observational study was used to generate data on prevalence and acceptability. Setting Antenatal, gynaecology and family planning clinics in Aberdeen, Edinburgh and Glasgow.Sample Prevalence was estimated in 2817 women. Acceptability was determined in 484 women.Methods An economic evaluation was performed using prevalence data from this and a previous study, and using outcome data from the literature and observational work. Incremental cost effectiveness ratios were estimated for each age group and clinical setting. Sensitivity analyses were performed to determine the robustness of incremental cost effectiveness ratios to changes in the incidence of long term sequelae and costs. The prevalence of infection was determined by nucleic acid amplification of urine samples or endocervical swabs. Knowledge of C. trachomatis and women's views of screening were determined using structured questionnaires. Main outcome measures Direct health service costs of screening, incidence and costs associated with adverse sequelae, women's views of screening and prevalence of infection. Results The estimated cost of screening 250 women in each age group in each the four sample populations (total population of 3750) is £49,367, while preventing 64 major sequelae. This represents a net cost of £771.36 in preventing one major sequela. Selective screening of all women under 20 years and all patients attending abortion clinics were shown to be the most cost effective strategies. These results were relatively insensitive to changes in estimated parameters, such as uptake rate, probabilities and unit costs of all major sequlae averted. Prevalence (95% CI) of infection in the highest risk groups (those aged under 20 in both antenatal and abortion clinics) was 12.1% (8.6 -16.7) and 12.7% (7.3 -21.2), respectively. The majority (>95%) of women agreed with a policy of regular screening for C. trachomatis, and screening in the settings employed in this study was largely acceptable. Conclusions A single episode of screening for C. trachomatis does not result in net cost savings. Currently recommended strategies of screening for C. trachomatis in women under 25 years of age in abortion clinics are supported by our data on prevalence and acceptability. These data also suggest that hospital-based screening strategies should be further extended to include younger women attending antenatal clinics and all women of reproductive age attending colposcopy clinics.